Dr. William B. Young, a neurologist at Thomas Jefferson University Hospital's Headache Center, and Joanna Kempner of Rutgers University in New Brunswick, N.J., said social stigma occurs when society disapproves of a person because they are different in some way -- either externally, as with a birthmark, or in an unseen way, as with migraine.

"When people treat my patients as if they are to blame because they have a severe, debilitating disease, they are contributing to the problem and making life harder for them," Young said in a statement.

The researchers surveyed 123 episodic migraine patients, 123 chronic migraine patients and 62 epilepsy patients using a 24-item stigma scale for chronic illness. They used epilepsy for comparison, a disease well-known for the associated stigma.

The study, published online in the journal PLOS ONE, showed patients with chronic migraine had higher scores on the stigma scale than either episodic migraine or epilepsy patients. Adjusted scores put migraine and epilepsy scores roughly equal.

Episodic migraine was defined as 14 headaches per month or fewer. Chronic migraine was greater than 14 headaches per month, with eight of these meeting the criteria for migraine.

The stigma was worse in those with chronic headache because the patients were more disabled, Young said.

"I don't think people realize that it is not unusual for people with migraine to have severe headaches every day -- to be so disabled that they are unable to work," Young said. "This is what causes the stigma -- the fact that people with severe migraine may not be able to work."

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